Trends in mortality after intensive care of patients with traumatic brain injury in Finland from 2003 to 2019 : a Finnish Intensive Care Consortium study

Show full item record



Permalink

http://hdl.handle.net/10138/340553

Citation

Luostarinen , T , Vehviläinen , J , Lindfors , M , Reinikainen , M , Bendel , S , Laitio , R , Hoppu , S , Ala-Kokko , T , Skrifvars , M & Raj , R 2022 , ' Trends in mortality after intensive care of patients with traumatic brain injury in Finland from 2003 to 2019 : a Finnish Intensive Care Consortium study ' , Acta Neurochirurgica , vol. 164 , no. 1 , pp. 87-96 . https://doi.org/10.1007/s00701-021-05034-4

Title: Trends in mortality after intensive care of patients with traumatic brain injury in Finland from 2003 to 2019 : a Finnish Intensive Care Consortium study
Author: Luostarinen, Teemu; Vehviläinen, Juho; Lindfors, Matias; Reinikainen, Matti; Bendel, Stepani; Laitio, Ruut; Hoppu, Sanna; Ala-Kokko, Tero; Skrifvars, Markus; Raj, Rahul
Contributor organization: HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki
Hyvinkää Hospital Area
Neurokirurgian yksikkö
HUS Neurocenter
HUS Emergency Medicine and Services
Department of Diagnostics and Therapeutics
Clinicum
Date: 2022-01
Language: eng
Number of pages: 10
Belongs to series: Acta Neurochirurgica
ISSN: 0001-6268
DOI: https://doi.org/10.1007/s00701-021-05034-4
URI: http://hdl.handle.net/10138/340553
Abstract: Background Several studies have suggested no change in the outcome of patients with traumatic brain injury (TBI) treated in intensive care units (ICUs). This is mainly due to the shift in TBI epidemiology toward older and sicker patients. In Finland, the share of the population aged 65 years and over has increased the most in Europe during the last decade. We aimed to assess changes in 12-month and hospital mortality of patients with TBI treated in the ICU in Finland. Methods We used a national benchmarking ICU database (Finnish Intensive Care Consortium) to study adult patients who had been treated for TBI in four tertiary ICUs in Finland during 2003-2019. We divided admission years into quartiles and used multivariable logistic regression analysis, adjusted for case-mix, to assess the association between admission year and mortality. Results A total of 4535 patients were included. Between 2003-2007 and 2016-2019, the patient median age increased from 54 to 62 years, the share of patients having significant comorbidity increased from 8 to 11%, and patients being dependent on help in activities of daily living increased from 7 to 15%. Unadjusted hospital and 12-month mortality decreased from 18 and 31% to 10% and 23%, respectively. After adjusting for case-mix, a reduction in odds of 12-month and hospital mortality was seen in patients with severe TBI, intracranial pressure monitored patients, and mechanically ventilated patients. Despite a reduction in hospital mortality, 12-month mortality remained unchanged in patients aged >= 70 years. Conclusion A change in the demographics of ICU-treated patients with TBI care is evident. The outcome of younger patients with severe TBI appears to improve, whereas long-term mortality of elderly patients with less severe TBI has not improved. This has ramifications for further efforts to improve TBI care, especially among the elderly.
Subject: Traumatic brain injury
Intensive care unit
Critical care
Mortality
Prognosis
Finland
EMERGENCY-DEPARTMENT VISITS
TEMPORAL TRENDS
DECOMPRESSIVE CRANIECTOMY
HEAD-INJURY
EPIDEMIOLOGY
MANAGEMENT
GUIDELINES
OUTCOMES
PATTERNS
DEATHS
3112 Neurosciences
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


Files in this item

Total number of downloads: Loading...

Files Size Format View
Luostarinen2022 ... MortalityAfterIntensiv.pdf 1.544Mb PDF View/Open

This item appears in the following Collection(s)

Show full item record